Paraphimosis in Dogs: Causes, Symptoms, and Treatment

Whether you call it the red rocket, lipstick, or simply an erection, this can be one of the more awkward parts of pet parenting. Dog erections happen, and most of the time, they can be a normal reaction to excitement and/or arousal. 

However, if the penis does not go back into the sheath within a short time, this can be a cause for concern and lead to damage to these delicate tissues. This condition, known as paraphimosis, is characterized by the penis remaining out of the sheath for a long time and being unable to retract on its own. 

Here’s everything you need to know about paraphimosis in dogs.

Main takeaways

• Paraphimosis is a condition in which a dog’s penis remains extruded from the skin for a prolonged time.

• This condition is considered a medical emergency, because the longer these tissues are exposed to the elements, the more damage can occur, putting them at risk for permanent injury.

• There are many possible causes for paraphimosis, and it is important to do all you can to prevent this condition.

What is paraphimosis in dogs? 

Canine paraphimosis is the inability of a dog to retract their erect penis back into the preputial sheath, which is the skin that covers the dog’s penis. When a dog’s penis won’t go back in, that can quickly turn into an emergency. The constriction of blood flow will lead to swelling, the drying out of these delicate tissues, and possibly necrosis, or death of these tissues. This can be very painful, block urination, and lead to even more serious consequences.

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What causes paraphimosis in dogs?

There are many possible causes for paraphimosis in dogs. In some dogs, this can be a congenital problem (or an issue they are born with), due to certain changes in their anatomy. For example, if the sheath — or skin around the penis — is too short, the penis may not be able to retract all the way.

Other times, this can be caused by trauma such as excessive humping or masturbating, prolonged intercourse with another dog, injuries to the penis itself, infections, foreign material stuck on or in the penis, and/or fur caught around the penis. Other times, the condition can occur due to problems with the surrounding structures such as muscle weakness, nerve damage, or cancer.

How do I know if my dog has paraphimosis?

A diagnosis of paraphimosis is generally based on the simple observation of the penis sticking out from the prepuce for a prolonged amount of time. Normally, the penis is completely retracted into the sheath and should not be visible, so if you are seeing the pink shiny tissues extruded from the sheath for longer than 20 minutes, you’ll want to be on high alert.

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What are the symptoms of paraphimosis in dogs? 

Symptoms of paraphimosis in dogs include:

• Prolonged exposure of the penis for more than 20 minutes

• Obsessively licking at the extracted penis

• Swelling and inflammation of the penis

• Discoloration of the exposed tissue or drying out of the tissues 

• Urine dribbling

Any of these signs warrant immediate veterinary attention. 

How is paraphimosis in dogs treated?

Treatment for paraphimosis is aimed at gently returning the penis to the sheath as soon as possible. Below are some home remedies for paraphimosis in dogs — but be warned, they’re not for the faint of heart. Also, keep in mind that this condition is both distressing and painful to dogs, so if your dog is giving you all the signs that they’re in pain (and not up for you touching them), head straight to the vet and don’t risk getting bitten or further injuring your pup. 

If your pup seems calm and is not in pain, you can attempt the following.

1. First, gently clean the exposed penis using lukewarm to cool water. Never rub the delicate tissues with anything rough or irritating. If your dog will permit it, inspect the penis for any foreign material such as foxtails or long fur that is wrapped around the base and “strangulating” the tissues of the penis. If you find any foreign material stuck in or around the penis, you’ll want to seek veterinary help to safely remove it without causing pain or further damage. 

2. Next, if the tissues look pink and healthy, try applying a gentle, water-based lubricant (such as KY Jelly) without any added ingredients like spermicide. Lubrication helps keep the tissues moist and will make it easier for the penis to slide back into the sheath. 

When should I take my dog to the vet for paraphimosis? 

If the penis remains out of the sheath for longer than 20 minutes and/or does not stay retracted once replaced, or if your dog seems very distressed and/or in pain, veterinary assistance is needed right away. Additionally, if you notice any damage to the tissue (including foreign objects stuck in or around the penis), bleeding, or discoloration of the tissue, it is important to have a vet assess the injuries, treat them appropriately, and provide necessary pain management.  

How is paraphimosis diagnosed by a veterinarian?

Paraphimosis is diagnosed based on the history and clinical presentation of the penis being persistently extruded, or repeatedly coming out of the sheath in a short time. There are many possible causes for this, so once your vet determines that this is the problem, they will start investigating the underlying cause.

How is paraphimosis treated by a veterinarian? 

The goal of treatment is to protect the delicate tissues of the penis, address the underlying cause, and prevent further damage by keeping the penis in the sheath. 

Treatment begins with carefully cleaning and lubricating the exposed penis and assessing for any signs of injury or damage to the tissue. Then, the vet will try to retract it back into the prepuce manually. This often requires sedation, because it can be uncomfortable, or even painful if there is already some injury to the tissues. 

In cases where the penis does not stay within the sheath, a minor surgical procedure may be necessary to put it in place with stitches. In severe cases of paraphimosis, especially if the penis has been exposed for a long time and/or sustained severe injuries, the tissue of the penis can die and partial amputation of the penis may be required. This is a more involved surgical procedure and typically requires hospitalization and intensive care.

Recovery and management of paraphimosis

Recovery and long-term management of paraphimosis will depend on the underlying cause and the severity of damage to the penis. For mild cases, where the penis was retracted quickly and did not have any major injuries, the recovery is usually speedy, and there is no need for long-term management. 

In cases where surgical intervention is required and/or there is more damage to the tissues, your vet will likely prescribe drugs including pain medication and antibiotics — and it is very important to use them as directed. Your vet will counsel you on what to watch for, and they may ask you to monitor the tissue for signs of discoloration or infection, and make sure your dog is able to urinate. If your dog is straining to urinate or does not urinate at all for more than eight hours, be sure to see a vet, because a urinary blockage can be life-threatening. 

How can paraphimosis be prevented? 

Depending on what caused the paraphimosis in the first place, preventative measures will vary. Neutering will decrease sexual excitement and behaviors like humping, which can cause injuries to the delicate tissues of the penis. For dogs who habitually hump certain objects, it is important to permanently remove those objects and practice leave-it cues and other strategies to redirect their behavior to safer activities. Also, be sure to keep your pup well-groomed, with the hair around the opening of the penis short to prevent irritation or strangulation. If you live in a place where your dog encounters fox tails and other seed pods, be sure to brush your dog after romping outdoors and consider using a coat and/or booties to limit their contact with these irritants.  

Can paraphimosis lead to complications? 

Yes, the tissues of the penis are not meant to be exposed for a long time. They need to remain moist and protected inside the sheath. When the penis is extruded for long periods, it puts those tissues at risk for drying out, trauma, and swelling, which can then cut off the blood supply. The longer this cycle continues, the more of a risk there is for permanent damage to the penis, including death of the  tissues, or necrosis. If this happens, the tissues cannot be repaired and penile amputation is necessary. The longer the penis is extruded, the more it causes distress and pain to your pup as well. For all of these reasons, this is considered a medical emergency requiring immediate veterinary attention. 

Bottom line

• There are many possible causes for a dog’s penis to become stuck in the extruded position.

• This is considered a medical emergency, because these delicate tissues can rapidly become damaged the longer they are exposed.

FAQs

How can I recognize paraphimosis?

A diagnosis of paraphimosis is generally based on the observation that the penis is extruded from the prepuce for longer than 20 minutes. You may also notice that your dog is distressed, in pain, and/or obsessively licking their penis.

Is paraphimosis an emergency?

Yes, if it persists for longer than 20 minutes and cannot be easily retracted, it is important to seek veterinary attention. The longer it goes on, the more the risk of permanent damage to these tissues. 

Can paraphimosis be a recurring issue?

Yes, paraphimosis can recur, whether it is due to behavioral, anatomical, or neurological issues. Be sure to discuss strategies to prevent recurrence with your vet.

How long does paraphimosis last?

A dog’s penis should normally retract within a few minutes, so anything longer than 20 minutes needs to be addressed immediately.

Can paraphimosis resolve on its own?

Yes, most of the time, a dog’s penis will retract on its own, and that is normal. 

What is the prognosis for dogs with paraphimosis?

This depends on the underlying cause and the severity of damage to their penis. In many cases, if the penis is replaced relatively quickly and with minimal damage, the prognosis is excellent. In cases where the damage is severe and/or the underlying cause is grave, such as a tumor, the prognosis may not be as good. 

Can dogs live with paraphimosis?

Dogs cannot live long-term with their penis extruded, because the tissues will become so severely damaged that they will die off, putting the dog at risk for life-threatening infections, sepsis, and/or an inability to urinate. There are, however, long-term solutions to treat paraphimosis and prevent these outcomes. 

How to fix paraphimosis at home?

You can attempt to retract a dog’s penis by applying a water-based lubricant and gently guiding it back into the sheath. If your dog is already distressed, in pain, or if there is a lot of swelling, it is best to seek veterinary attention right away to prevent further damage. 

References

• Davidson, Autumn. “Paraphimosis in Dogs and Cats.” Merck Veterinary Manual. July 2020.

• Oursler, Teri. “Paraphimosis and Phimosis in Dogs and Cats.” Veterinary Partner. 17 March 2022.

• Somerville, Mary et al. “Phallopexy for Treatment of Paraphimosis in the Dog.” Journal of the American Animal Hospital Association, vol. 37, 2001, pp: 397-400.